HEALTH TRAIN EXPRESS
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Saturday, October 24, 2009

Hal Scherz is just one of the many willing to get down and invest his own capital in growing our grass roots efforts to influence health reform. This is one of those things our organizations just cannot do as well. Your interest,contributions and participation are essential.

As Dr Scherz states:

""I know how much everyone enjoys opening my TNTC emails (LOL) and I'm sure that you must have wondered where I disappeared to. I was down most of this week with what I'm convinced was H1N1, although the ER wouldn't test me. (A taste of what we have to look forward to under Obamacare). Now that I'm strong enough to sit up, I can start bothering everyone again. If you had any emails bounce back, please resend them. My box was filled up because I didn't clean it out for 5 days. If you sent me an email in the last few days, I promise that I will read it over the next 48 hours.

There are 2 things that I wanted to address tonight. As I have indicated to everyone, Docs 4 Patient Care will be an embedded sponsor of the Mike Gallagher show.

This is more like a partnership, because he has a strong, personal reason for wanting the doctor-patient relationship to be protected. Please begin to go to Mike's web site (http://www.mikeonline.com/) beginning on Monday and you will see Docs 4 Patient Care featured prominently. The exciting news regarding this, is that Mike is doing a 3 hour healthcare show this Thursday, Oct 29, and his co-host will be Hal Scherz. Yes, you didn't misread this. We will be discussing every aspect of the healthcare debate and we will try to have a guest or 2 to help to clarify the issues. His show is predominantly an audience participation show, so it would be a great opportunity for everyone to try to call in and to say what you would like to his national audience. If you are not familiar with his show, find out online which station his show is broadcast on in your area. It might even be a good idea to put this show on in your office waiting room and see if the hospitals will put this through into the doctors' lounges.

The second other important issue that I wanted to cover has to do fundraising. Please don't stop reading- this is different than usual.

I have received feedback from people that I have known professionally for over 20 years who I have reached out to in different parts of the country. When they heard about what we were putting together and that my practice was so committed, that we were putting up $40,000 in seed money, it was a "no brainer" for them. However, they are trying to convince people that they work with in their communities to dig into their pockets and write big checks. They are a bit reluctant because they don't know us, and they aren't sure where their money is going.

These are fair questions and concerns. First, let me assure everyone, that as a not for profit 527 political corporation, everything that we collect and spend has to be above board and transparent. If any member has any questions, they can contact our treasurer and board member, Joanne Thurston, who is a CPA.

Another question was whether I or any of the other officers have received any compensation. I wish. The truth is that not only do we not receive compensation, but we continue to put up our own money without asking for reimbursement for business related items- business cards, signs, etc. We have been to Washington twice already, and use our own money for these trips. And except for the past 4 days that I have taken off because of illness, I have averaged 5 hours of work daily for the past 5 months without any compensation. Anyone who sees what time the majority of my emails are timed can attest to this.

As to where does the money go? Well, there were start up expenses which we won't go into. But there are ongoing costs every month- mostly web site maintenance and our PR team. There are intermittent costs such as legal, marketing, other consultants.

However, we are now ready for prime time. We either move to the next level or pack up our toys and go home. What this means is that we spend a large amount of money getting out our message on a national platform and on a regular basis. This will open up more doors to us than we can possibly even imagine at this point. We need to hire an executive director, who will help to take the burden off of me. There are still many large initiatives that we need to launch, such as putting together the thousands of newsletter recipients who are not doctors and whose energy and enthusiasm is being wasted. We need to get these people working for us and contributing to our cause. The same for the allied health care professionals. There are thousands of doctors that we could get into Docs 4 Patient Care. We are poised for explosive growth. We need help to make this happen. We would like to at some point hire our own lobbyists and this will be very expensive. And there is so much more than this.

So this is where the money is going. Most of you getting this email don't know me at all, although there are ways to check on people today that didn't exist in the past. However, I think that it is worth taking a flier on this one. Do you want to write a big check in hopes that your money will actually work for you, or do you want to pretend that everything will be ok and hope that if you play nice and don't make too much noise, that you'll be left alone? This is almost too insulting to even ask this question.

Enough tonight. But those who want to contribute but just aren't sure, just do it! ""

Tuesday, October 20, 2009

I have taken a break from health reform politicking to return to some essentials about health IT.

” The definition of a pioneer is “the guy with the arrow through his head.”

This was just one of the 'takeaways" at a recent seminar hosted in San Diego regarding the IT stimulus money train.

The feds have not defined “meaningful user” or “certified” yet; they are key requirements of the plan.

MEANINGFUL USER IS IN THE EYES OF THE BEHOLDER. ONLY PART OF THE DEFINITION HAS BEEN ESTABLISHED, AND NOT BY THE USERS THEMSELVES....TIME WILL TELL WHICH AND WHAT IS MEANINGFUL AND IT MAY TURN OUT THAT MEANINFUL (DEFINITION) WILL CHANGE IN THE NEXT FIVE YEARS.

ARE WE GOING TO BE CAST INTO A USELESS MOLD?

Financial incentives, even the full $44,000 available, are not going to cover your investment.

The cost difference between implementing in 2012 versus 2011 is only $5,000 less (paid out over 5 years). That year could be huge. The definition of an early adopter is the “bug on the windshield of progress.” The definition of a pioneer is “the guy with the arrow through his head.” One year to let others make the mistakes may save you much more than $5,000.

WHY ARE THE FEDS IN SUCH A HURRY WITH CUT OFF DATES AND PENALTIES FOR NOT IMPLEMENTING HIT AND EHR BY 2012???

COULD IT BE THAT THE FEDS ARE IN BED WITH SOME BIG IT PLAYERS??? ALLSCRIPTS IS BUSY RUNNING NATIONAL SEMINARS ON 'HOW TO" (DIP INTO THE FEDERAL TREASURY)

DON'T SPEND MY MONEY!!!

If you implement a bad process, you still have a bad process. Now is the time to dig into your operations, make them better, and THEN automate.

There are four “I”s that are key in shopping for an EHR/EMR:

Implementation—This is the hardest part; it can sink you, and the vendors may not there for the long haul.

Identity—How are you going to secure your data? Big penalties for doing it badly.

Interoperability—Will it work with a MAC, your hardware, your PM system?

Intersection—Will it work with the hospital/s, or the IPA/s, or any other of the as-yet-unnamed entities that will be required? THANKS TO MODERN MEDICINE, AND JUDY BEE

Wednesday, October 14, 2009

Quote of the Day: Intelligence without ambition is a bird without wings. --C. Archie Danielson

MGMA: Many Physician Groups Not Yet Ready To Invest in EHRs

Many physician group practices are likely to delay electronic health record adoption because of logistical and financial concerns, experts said this week at the Medical Group Management Association's annual convention, Healthcare IT News reports.

MGMA represents 22,500 medical group administrators and managers from across the country.

Robert Tennant, senior policy adviser for MGMA, said most of the physician practices MGMA represents will not qualify by 2011 for incentive payments under the federal economic stimulus package.

Under the stimulus package, health care providers who demonstrate "meaningful use" of EHRs will qualify for incentive payments through Medicare and Medicaid. However, the federal government has yet to issue a final definition for meaningful use.

William Jessee, CEO of MGMA, said many physician practices experienced declining revenue in 2008. He noted that nearly 37% of MGMA members have said they are postponing capital expenditures, which could include EHR adoption (Healthcare IT News, 10/13).

Moreover, many physician groups are concerned that the federal government will reduce Medicare payment rates this year under its sustainable growth rate formula, Jessee said.

He added that uncertainty about the rate reductions is leading many medical groups to delay EHR implementation (Monegain, Healthcare IT News, 10/13).

It seems as if many physicians are reticent to spend money they do not have. (unlike our federal government). Despite all the rhetoric and politically incorrect statements about how much HEALTH IT will save, the government programs will have physicians lay out the funds to start up the HIT transition and will only receive grants if they can prove they are using EMR effectively (meaningfully) and according to a standard which has yet to be defined by them. The deadline is 2011 for implementation. This is less than one year from the probably final passage of any health reform bill. Although the original stimulus funding took place several months ago, the reality of these funds filtering down to the medical community will take at least another 12 months, based upon previous experience with ARRA and other stimulus packages.

Tuesday, October 13, 2009

An argument is the longest distance between two points of view. --Dan Bennett

Gov. Arnold Schwarzenegger vetoed AB 2 over the weekend, rejecting legislation that would put a stop to the insurance industry's outrageous practice of wrongfully canceling patients' coverage once they get very sick and run up large medical bills, the Los Angeles Times and other major papers report. Sponsored by the California Medical Association, AB 2 called for an independent review of decisions by insurers to rescind coverage.

The insurance industry's widespread abuse of the practice has drawn condemnation from Republicans and Democrats alike.

In June, a congressional investigation found that three insurers had rescinded coverage for 20,000 patients over five years, saving their companies $300 million.

"With this veto, the Governor told Californians that insurance company profits are more important than their access to health care when they get sick and treatment becomes costly," said Dev GnanaDev, CMA president. "Without the patient protections of legislation like AB 2, there is no guarantee that Californians will have health insurance when they need it most."

Dev GnanaDev, president of the California Medical Assn., said Schwarzenegger's veto told Californians that "insurance company profits are more important than their access to healthcare." Insurance firms and business leaders countered that the bill proposed unnecessary regulation and would have hurt the state's economic recovery.

Monday, October 12, 2009

This it ! A.H.I.P. chose to announce their disfavor on a Monday morning, which also happens to be a Federal Holiday. It also came just after the latest media news cycle closed. Scouring my blog list I did not see any mention of this perfidity of the AHIP.

I seem to remember several months ago how the head of Wellpoint announced how they were cooperating with the reform plans. What happened? Perhaps they don't like the idea of offering coverage to the uninsured, the sick and ill, and whoever else they can't make a buck off of.

Deep in the recesses of their accounting departments they have now estimated that the reform measures proposed by the Senate Finance Committee would increase a family's premiums by 4500 dollars/year. I guess what they are saying is "Sure, we'll participate in reform, but it's going to cost 4500 dollars/year for most families. " GIVE US A BREAK !

Reconciliation

Word over all, beautiful as the sky, Beautiful that war and all its deeds of carnage must in time be utterly lost, That the hands of the sisters Death and Night incessantly softly wash again, and ever again, this solid world; For my enemy is dead, a man divine as myself is dead, I look where he lies white-faced and still in the coffin--I draw near, Bend down and touch lightly with my lips the white face in the coffin.

WASHINGTON (AP) - The fever has broken. The patient is out of intensive care. But if you're President Barack Obamayou can't stop pacing the waiting room. Health care...

Thanks to all of you...to the Todd Rubins, Scott Barbours, and Hal Scherz.....who participated and led the Million Med March last week. We haven't heard anything from the doctors at the White House Rose Garden Tea Party, as yet.

As you may know these docs were all fervent supporters of Obama's campaign for President. Not much dissent there, and a safe bet for no demonstrations on the White House lawn. This was a real dog and pony show and a definite chance to land an autograph photo for that office wall.

Monday, October 5, 2009

So, what is the agenda? There may be a hint of what will take place in an article in Medpage Today, describing Mr. Obama’s vision for health reform in America.

Here are President Obama's takeaway points:

"I don't believe malpractice reform is a silver bullet, but I have talked to enough doctors to know that defensive medicine may be contributing to unnecessary costs. So I am proposing that we move forward on a range of ideas about how to put patient safety first and let doctors focus on practicing medicine. I know the Bush administration considered authorizing demonstration projects in individual states to test these issues. It's a good idea, and I'm directing my Secretary of Health and Human Services to move forward on this initiative today."

"The only thing this plan would eliminate [in Medicare] is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies ..."

To date, the White House has detailed hundreds of billions of dollars in cuts to the Medicare program. First, the administration outlined $634 billion in savings, about half of which would come from cuts to Medicare and Medicaid. These include elimination of overpayment to Medicare Advantage plans.

And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies -- because there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives

There are those who claim that our reform effort will insure illegal immigrants. This, too, is false. The reforms I'm proposing would not apply to those who are here illegally"

"Some of people's concerns have grown out of bogus claims spread by those whose only agenda is to kill reform at any cost. The best example is the claim ... that we plan to set up panels of bureaucrats with the power to kill off senior citizens. It is a lie, plain and simple."

I know I will sleep much better tonight after our physician leaders meet with President Obama, knowing that our healthcare reform has been solved…

Sunday, October 4, 2009

"Some of you may recognized this telephone number", states Congressman Tom Price MD R- . "It' the White House"

Here is what he is asking us to do:

1. CALL THE WHITE HOUSE ON MONDAY! The President is meeting with a hand picked group of docs who agree with him. He needs to hear from doctors in the community who disagree with him. CALL ON MONDAY TO:

202-456-1414

2. Encourage your Physician Colleagues to do the same. Forward this email to: your medical associations, post the phone number of doctor dining room, bulletin boards and talk to your colleagues in the corridor.

3. ENCOURAGE YOUR PATIENTS TO CALL THE WHITE HOUSE TO SAY “NO TO MANDATES, RATIONING, and THE PUBLIC OPTION”.

The rest of the story.....October 1 has come and gone. The group had another successful day barnstorming the capitol building. Hal, Scott and Todd as well as many other members of Docs4Patient Care started their own filibuster and nearly shut down several senator's and other congressional offices. I spoke with Senator Joe Lieberman's office and they too were being 'lobbied' by our group as well as many other individual physicians.

The alliance of providers and patient advocacy is a powerful platform for patients and physicians.

Perhaps one of the new regulations in health reform will be a HICO score that parallels your FICO score. Or perhaps we need a 'truth in health insurance " law that parallels the 'truth in lending " law.

Disclaimer

The opinions in this blog or other forms of social media are solely that of Gary M. Levin M.D. Dr. Levin has no financial interests in any medical devices which are discussed or which appear in the blog. Commentary taken from other sources are either quoted or referenced with attribution. Dr Levin does not endorse, nor give financial support to any political organizations.